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EP0949881A4 - Piece a main chirurgicale - Google Patents

Piece a main chirurgicale

Info

Publication number
EP0949881A4
EP0949881A4 EP97940679A EP97940679A EP0949881A4 EP 0949881 A4 EP0949881 A4 EP 0949881A4 EP 97940679 A EP97940679 A EP 97940679A EP 97940679 A EP97940679 A EP 97940679A EP 0949881 A4 EP0949881 A4 EP 0949881A4
Authority
EP
European Patent Office
Prior art keywords
nosepiece
linear actuator
handpiece
housing
solenoid
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
EP97940679A
Other languages
German (de)
English (en)
Other versions
EP0949881B1 (fr
EP0949881A1 (fr
Inventor
John Joseph Weidenbenner
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Bausch and Lomb Inc
Original Assignee
Bausch and Lomb Surgical Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Bausch and Lomb Surgical Inc filed Critical Bausch and Lomb Surgical Inc
Publication of EP0949881A1 publication Critical patent/EP0949881A1/fr
Publication of EP0949881A4 publication Critical patent/EP0949881A4/fr
Application granted granted Critical
Publication of EP0949881B1 publication Critical patent/EP0949881B1/fr
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

Links

Classifications

    • G—PHYSICS
    • G05—CONTROLLING; REGULATING
    • G05G—CONTROL DEVICES OR SYSTEMS INSOFAR AS CHARACTERISED BY MECHANICAL FEATURES ONLY
    • G05G1/00—Controlling members, e.g. knobs or handles; Assemblies or arrangements thereof; Indicating position of controlling members
    • G05G1/30—Controlling members actuated by foot
    • G05G1/305—Compound pedal co-operating with two or more controlled members
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B50/00—Containers, covers, furniture or holders specially adapted for surgical or diagnostic appliances or instruments, e.g. sterile covers
    • A61B50/10—Furniture specially adapted for surgical or diagnostic appliances or instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B50/00—Containers, covers, furniture or holders specially adapted for surgical or diagnostic appliances or instruments, e.g. sterile covers
    • A61B50/10—Furniture specially adapted for surgical or diagnostic appliances or instruments
    • A61B50/13—Trolleys, e.g. carts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B50/00—Containers, covers, furniture or holders specially adapted for surgical or diagnostic appliances or instruments, e.g. sterile covers
    • A61B50/10—Furniture specially adapted for surgical or diagnostic appliances or instruments
    • A61B50/15—Mayo stands; Tables
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/00736—Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/00736—Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments
    • A61F9/00745—Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments using mechanical vibrations, e.g. ultrasonic
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/00736—Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments
    • A61F9/00763—Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments with rotating or reciprocating cutting elements, e.g. concentric cutting needles
    • G—PHYSICS
    • G08—SIGNALLING
    • G08C—TRANSMISSION SYSTEMS FOR MEASURED VALUES, CONTROL OR SIMILAR SIGNALS
    • G08C19/00—Electric signal transmission systems
    • G08C19/16—Electric signal transmission systems in which transmission is by pulses
    • G08C19/28—Electric signal transmission systems in which transmission is by pulses using pulse code
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
    • G16H40/60—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices
    • G16H40/63—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for local operation
    • H—ELECTRICITY
    • H02—GENERATION; CONVERSION OR DISTRIBUTION OF ELECTRIC POWER
    • H02H—EMERGENCY PROTECTIVE CIRCUIT ARRANGEMENTS
    • H02H3/00—Emergency protective circuit arrangements for automatic disconnection directly responsive to an undesired change from normal electric working condition with or without subsequent reconnection ; integrated protection
    • H02H3/12—Emergency protective circuit arrangements for automatic disconnection directly responsive to an undesired change from normal electric working condition with or without subsequent reconnection ; integrated protection responsive to underload or no-load
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/3201—Scissors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A—HUMAN NECESSITIES
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    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00022—Sensing or detecting at the treatment site
    • A61B2017/00026—Conductivity or impedance, e.g. of tissue
    • A61B2017/0003—Conductivity or impedance, e.g. of tissue of parts of the instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00022—Sensing or detecting at the treatment site
    • A61B2017/00057—Light
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00137—Details of operation mode
    • A61B2017/00154—Details of operation mode pulsed
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00137—Details of operation mode
    • A61B2017/00154—Details of operation mode pulsed
    • A61B2017/00181—Means for setting or varying the pulse energy
    • A61B2017/00185—Means for setting or varying the pulse height
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00137—Details of operation mode
    • A61B2017/00154—Details of operation mode pulsed
    • A61B2017/00181—Means for setting or varying the pulse energy
    • A61B2017/0019—Means for setting or varying the pulse width
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00199—Electrical control of surgical instruments with a console, e.g. a control panel with a display
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00221—Electrical control of surgical instruments with wireless transmission of data, e.g. by infrared radiation or radiowaves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0042—Surgical instruments, devices or methods, e.g. tourniquets with special provisions for gripping
    • A61B2017/00429—Surgical instruments, devices or methods, e.g. tourniquets with special provisions for gripping with a roughened portion
    • A61B2017/00433—Surgical instruments, devices or methods, e.g. tourniquets with special provisions for gripping with a roughened portion knurled
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00477—Coupling
    • A61B2017/00482—Coupling with a code
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00535—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
    • A61B2017/00544—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated pneumatically
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00973—Surgical instruments, devices or methods, e.g. tourniquets pedal-operated
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00973—Surgical instruments, devices or methods, e.g. tourniquets pedal-operated
    • A61B2017/00977—Surgical instruments, devices or methods, e.g. tourniquets pedal-operated the depression depth determining the power rate
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B50/00—Containers, covers, furniture or holders specially adapted for surgical or diagnostic appliances or instruments, e.g. sterile covers
    • A61B50/10—Furniture specially adapted for surgical or diagnostic appliances or instruments
    • A61B50/15—Mayo stands; Tables
    • A61B2050/155—Mayo stands
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B50/00—Containers, covers, furniture or holders specially adapted for surgical or diagnostic appliances or instruments, e.g. sterile covers
    • A61B50/10—Furniture specially adapted for surgical or diagnostic appliances or instruments
    • A61B50/18—Cupboards; Drawers therefor
    • A61B2050/185—Drawers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/361—Image-producing devices, e.g. surgical cameras
    • A61B2090/3614—Image-producing devices, e.g. surgical cameras using optical fibre
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61B2217/00—General characteristics of surgical instruments
    • A61B2217/002—Auxiliary appliance
    • A61B2217/005—Auxiliary appliance with suction drainage system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2217/00—General characteristics of surgical instruments
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B50/00—Containers, covers, furniture or holders specially adapted for surgical or diagnostic appliances or instruments, e.g. sterile covers
    • A61B50/20—Holders specially adapted for surgical or diagnostic appliances or instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/30—Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
    • A61G12/00—Accommodation for nursing, e.g. in hospitals, not covered by groups A61G1/00 - A61G11/00, e.g. trolleys for transport of medicaments or food; Prescription lists
    • A61G12/001—Trolleys for transport of medicaments, food, linen, nursing supplies
    • A—HUMAN NECESSITIES
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    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/12—General characteristics of the apparatus with interchangeable cassettes forming partially or totally the fluid circuit
    • A—HUMAN NECESSITIES
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    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/50—General characteristics of the apparatus with microprocessors or computers
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    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/60—General characteristics of the apparatus with identification means
    • A61M2205/6063—Optical identification systems
    • A61M2205/6081—Colour codes
    • H—ELECTRICITY
    • H01—ELECTRIC ELEMENTS
    • H01H—ELECTRIC SWITCHES; RELAYS; SELECTORS; EMERGENCY PROTECTIVE DEVICES
    • H01H3/00—Mechanisms for operating contacts
    • H01H2003/008—Mechanisms for operating contacts with a haptic or a tactile feedback controlled by electrical means, e.g. a motor or magnetofriction
    • H—ELECTRICITY
    • H01—ELECTRIC ELEMENTS
    • H01H—ELECTRIC SWITCHES; RELAYS; SELECTORS; EMERGENCY PROTECTIVE DEVICES
    • H01H2300/00—Orthogonal indexing scheme relating to electric switches, relays, selectors or emergency protective devices covered by H01H
    • H01H2300/04—Programmable interface between a set of switches and a set of functions, e.g. for reconfiguration of a control panel

Definitions

  • This invention relates generally to microsurgical and ophthalmic systems and, particularly, to a control system which utilized various surgical instruments to a handpiece intended for ophthalmic surgical scissors of the "vertical" type, which handpiece can be activated by a foot pedal controlled linear solenoid motor and such handpiece 's method of manufacture.
  • Present day ophthalmic microsurgical systems provide one or more surgical instruments connected to a control console.
  • the instruments are often electrically or pneumatically operated and the control console provides electrical or fluid pressure control signals for operating the instruments.
  • the control console usually includes several different types of human actuable controllers for generating the control signals supplied to the surgical instruments. Often, the surgeon uses a foot pedal controller to remotely control the surgical instruments.
  • intraocular surgical scissors is well known. While manually operated scissors are still in widespread use worldwide, they suffer from the disadvantage of being subject to human limitations on speed and accuracy.
  • the use of surgical scissors with electric motor drive is also widespread.
  • Electrical motor driven scissors are divided into two well known types based upon the type of drive, those that are solenoid actuated and those that are driven by a direct current motor or "proportional" control.
  • Most intraocular scissors have design similarities in which a pair of cutting blades extend from the end of a tubular "needle", with one blade being fixed and the other, opposed blade end being reciprocated between an open and a closed position with respect to the fixed blade. This reciprocating motion is accomplished through the action of one of the driving systems mentioned, such as, for example, a manual or electric motor drive.
  • Electric motor drivers of either rotary or linear solenoid type activate scissor closure by controlled transfer of the motor energy to the movable blade.
  • the scissors may be of the "vertical” design (the guillotine, or the parallel blade type), the angled or “horizontal” style, or of another design, or the driver may instead be used to actuate other instruments, besides scissors, that operate similarly.
  • the linear solenoid type of drive provides a reciprocating action in which the electrical actuation of a solenoid causes the movable blade to move to the closed position m relation to the fixed blade and then, usually through the operation of a spring within the hub of the scissors, to return to the open position.
  • a handpiece of this type is seen in the patent which issued to Lo et al . , U.S. Patent Number 5,275,607.
  • solenoid actuated scissors handpieces It is characteristic of solenoid actuated scissors handpieces that the cutting action provided be a rapid, snipping action, due to the fast firing of the solenoid plunger or piston.
  • the solenoid actuated style of handpiece is appropriate for use with a surgical scissor of the known guillotine type, such as (as one example only) the scissor tip presently offered by STORZ ® Ophthalmic
  • the proportional type of motor control such as is provided by a stepper motor is appropriate for use when the operating instrument is a forceps or a conventional "horizontal" style of ophthalmic scissors or other instrument (e.g. ERGOTEC t p E8500 or E8600) .
  • the new handpiece described herein for use with a solenoid motor is capable of using a known type of surgical instrument tip, without the necessity of alteration or adaptation of the instrument.
  • the solenoid actuated handpiece described herein, including the unique nosepiece element of the handpiece, and the method of assembling the new handpiece directly address the problem of variations in dimensions of machined parts and provide an improved solenoid actuated handpiece for ophthalmic surgical instruments, which handpiece has increased reliability of operation and durability.
  • the new handpiece construction may also be well suited for other types of electrically operated surgical instruments.
  • the new handpiece and the nosepiece thereof be so limited in use.
  • the nosepiece element is described herein specifically in relation to the new handpiece as a whole, it is certainly conceivable that the nosepiece could be used, when constructed exactly as described or with reasonable and appropriate modifications, with other styles of handpieces, potentially even a manually operated style of handpiece.
  • the nosepiece can be connected to a linear actuator in a preselected position and also be capable of operable connection to a surgical instrument, it is considered to be within the scope of the invention.
  • the new handpiece be simple m construction relative to known devices and that it thus be relatively facile and economical to manufacture. Moreover, the new handpiece s intended to be controlled by a foot pedal connected to a new modular electronic control unit, as described elsewhere herein.
  • the invention is, briefly, a handpiece for actuating a surgical instrument connected to the handpiece.
  • the new handpiece includes a housing and a linear actuator operatively retained within the housing.
  • a nosepiece is mounted to one end of the housing and is adapted for connection of a linearly actuated surgical instrument.
  • the nosepiece is fixed to the linear actuator m a preselected calibrated position relative to the longitudinal axis of the linear actuator and the other end of the housing is enclosed and liquid-tight .
  • the invention is also, briefly, a nosepiece for connecting a surgical instrument to a linear actuator m a preselected position relative to a longitudinal axis of the linear actuator.
  • the nosepiece is mountable to the linear actuator and includes structure for detachable connection of the nosepiece to a surgical instrument, and structure for adjustably mounting the nosepiece to the linear actuator and for fixing the nosepiece to the linear actuator in a preselected position.
  • the invention is still further, briefly, a method of manufacturing a handpiece for surgical instruments actuated by a linear actuator.
  • the method includes constructing a nosepiece assembly for the handpiece by a) placing a slide fit seal and a press fit washer into a nosepiece, b) adjustably introducing a forwardly directed end of a linear actuator into the nosepiece, c) inserting a plunger of the linear actuator into a rearwardly directed end of the nosepiece, d) holding the plunger of the linear actuator in the inserted position m the nosepiece, e) calibrating the longitudinal position of the linear actuator relative to the nosepiece, which longitudinal position is required to achieve operative contact of the plunger of the linear actuator with an actuator pin of a surgical instrument which is connectable to the nosepiece, and f) fixing the longitudinal position of the linear actuator at the calibrated setting.
  • Fig. 1 is a perspective view of a microsurgical control system for use with ophthalmic microsurgical instruments, and having a plurality of control modules utilizing a variety of surgical handpieces in accordance with the present invention
  • Fig. 2 is a side elevation of a scissors handpiece embodying the present invention, nearly fully assembled
  • Fig. 3 is a side elevation of a nosepiece of the handpiece of Fig. 2 ;
  • Fig. 4 is a top plan of the nosepiece of Fig. 3 , •
  • Fig. 5 is a bottom plan of the nosepiece of Fig. 3;
  • Fig. 5A is a schematic side elevation of the nosepiece of the handpiece of Fig. 2, enlarged for clarity and showing the internal contours in phantom;
  • Fig. 6 is an exploded side elevation of the handpiece of Fig. 2 with the scissors removed for clarity;
  • Fig. 7 is an elevation taken on line 7-7 of Fig. 6, showing the internal aspects of the handpiece and power cord interconnection, with the wiring moved aside, for clarity;
  • Fig. 8 is a perspective of a tailpiece of the handpiece of Fig. 2, enlarged for clarity;
  • Fig. 9 is a schematic side view of the nosepiece and a solenoid assembly of the handpiece of Fig. 2, enlarged for clarity and showing the position of the unactuated solenoid piston in phantom.
  • Fig. 1 illustrates a microsurgical control system, generally designated 1, according to a preferred embodiment of the present invention.
  • the system 1 includes a computer unit 3 having a flat panel display 5, a base unit 7 housing a plurality of modules 13, and peripherals such as a foot control assembly 15 and a motorized intravenous (IV) pole assembly 17 (each of which is generally indicated by its respective reference numeral) .
  • Each of the modules 13 housed in the base unit 7 controls at least one ophthalmic microsurgical instrument 19 for use by a surgeon in performing various ophthalmic surgical procedures .
  • ophthalmic microsurgery involves the use of a number of different instruments 19 for performing different functions.
  • These instruments 19 include vitrectomy cutters, phacoemulsification or phacofragmentation handpieces, electric microscissors, fiber optic illumination instruments, coagulation handpieces and other microsurgical instruments known in the art.
  • their operating parameters differ according to, for example, the particular procedure being performed, the different stages of the procedure, the surgeon's personal preferences, whether the procedure is being performed in the anterior or posterior portion of the patient's eye, and so on.
  • an instrumentation cart supports system 1.
  • the cart 21 includes a surgical, or Mayo, tray 25, the automated IV pole assembly 17, a storage compartment 27 for stowing the foot control assembly 15, disposable packs and other items, an opening 33 to house an expansion base unit (not shown in Fig. 1) , and rotating casters 35.
  • Base unit 7 and computer unit 3 preferably sit on top of instrumentation cart 21 as shown in Fig. 1 and the Mayo tray 25 is mounted on an articulating arm (not shown) preferably attached to the top of instrumentation cart 21, directly beneath base unit 7.
  • Instrumentation cart 21 also holds a remote control transmitter, generally indicated 39, for use in remotely controlling system 1.
  • the modules 13 in base unit 7 house control circuits for the various microsurgical instruments 19 so that the system's user is able to configure system 1 for optimizing its use by the surgeon.
  • Modules 13 include connections or ports by which one or more microsurgical instruments 19 connect to each module 13 and house the necessary control circuitry for controlling operation of the particular instrument or instruments 19 connected thereto.
  • the user by inserting the desired modules 13 in base unit 7, configures system 1 to meet a particular surgeon's preference, to control each of the instruments 19 needed for a particular surgical procedure, or to otherwise optimize system 1 for use by the surgeon.
  • 1810 generally designates a handpiece constructed in accordance with and embodying the present invention.
  • the handpiece 1810 is for use with a module 13 and, particularly, with a scissors module 3, more fully described in copending application which is hereby incorporated by reference.
  • Handpiece 1810 is, in basic terms, composed of a central housing 1812 having a nosepiece 1814 connected at the forward or working end of housing 1812 and a tailpiece 1816 connected at the opposed, rearwardly directed end of housing 1812.
  • forward refers to the end of handpiece 1810 to which a surgical instrument is operatively connected
  • “rearward” refers to the end of the handpiece attached by a power cable 1820 to a control device .
  • Housing 1812 is preferably elongated and cylindrical as shown, but could of course take other general forms, as long as the structure is suitably conformed to be held by hand (or conceivably, and alternatively, by a robotic grasping device which functions as a surgeon's hand) and to receive and retain a linear, solenoid motor and connect to (preferably by press-fit construction) the tailpiece 1816 and nosepiece 1814, to be described.
  • Tailpiece 1816 is preferably a single piece and formed of stainless steel. However, other materials and constructions exist or can be conceived which will suffice. Ordinarily the tailpiece is circular in cross-section to properly engage and seal the rearwardly directed end of housing 1812. However, should the cross-sectional shape of the housing be altered, a corresponding change can be incorporated into the tailpiece to ensure a secure, liquid- tight fit between the two pieces.
  • tailpiece 1816 has a tubular extension 1822 to which is connected a cable strain relief 1818 (shown in Figs. 2 and 6) which extends rearwardly and receives and protects a conventional power cable 1820 (which is connected to the control module 13 previously mentioned) from strains and stresses caused by twisting, pulling and bending in the normal course of use of handpiece 1810.
  • Cable relief 1818 is desirably formed of silicone or some other suitably pliable substance which is strong, yet somewhat flexible and is preferably molded to extension 1822 or otherwise applied thereover as a sleeve and which is easy to clean.
  • Tubular extension 1822 of tailpiece 1816 intersects and is contiguous with an intermediate section 1824 which is provided on the forwardly directed end thereof with a flange 1826 which abuts the rearwardly directly annular open end of housing 1812.
  • Extending forwardly from flange 1826 is a cylindrical insertion section 1828 which is of sufficient size to press fit into the rearwardly directed end 1832 of housing 1812.
  • tailpiece 1816 is provided with an annular groove 1830 which serves as a seat for a conventional O-ring (not shown) , to thereby further ensure a liquid-tight seal with the inside wall of rearwardly directed end of housing 1812.
  • a conventional O-ring not shown
  • tailpiece 1818 which will acceptably serve the purposes of enclosing the tail end (power cord end) of housing 1812 while simultaneously providing strain relief for power cable 1820.
  • the rearwardly directed end 1832 of housing 1812 is illustrated as being somewhat tapered, axially inwardly, relative to the main body of the housing. Although this design is preferred, other forms are suitable for this area of device 1810 that will not substantially affect the function of the device.
  • housing 1812 be formed of stainless steel, but of course other materials both existing and possibly to be developed will suffice if the material is strong, durable and capable of being repeatedly disinfected as may be necessary after the medical procedure for which handpiece 1810 is used. If desired, housing 1812 may be provided with a coating, for example of an elastomer, applied by molding or otherwise, to improve user comfort. Although, as discussed above, it is intended that handpiece 1810 be connected to a power source by a conventional power cable 1820, it is conceivable that handpiece 1810 could alternatively, or additionally, be provided with a battery as a source of power.
  • a battery of appropriate size and power could be disposed within the rearwardly directed end of housing 1812 and a control switch could be incorporated into handpiece 1810 or in connection therewith so that the surgeon could operate handpiece 1810, for example, in remote locations, without requiring the entire modular control unit previously discussed as the preferred form of the invention.
  • Figs. 2, 6 and 7 illustrate that the forwardly directed end 1834 of housing 1812 longitudinally receives a known linear solenoid 1836, which is connected by lead wires 1838 to power cable 1820 in the usual manner.
  • a suitable solenoid presently available is marketed by the Lucas Company and referred to as an STA Series Push type.
  • the solenoid carrying part number 195203-331 is particularly appropriate and is approximately one inch long and about one half inch wide, with a plunger that is approximately one and seven eighths inch long.
  • a plunger or piston 1840 is slideably disposed longitudinally within solenoid 1836 so as to be actuated forwardly when the solenoid is signaled via the previously mentioned foot control 15.
  • the forwardly directed end of solenoid 1836 is provided with male external threads 1842 for ad ⁇ ustable connection to nosepiece 1814, which will be described hereafter.
  • the male thread on end 1842 is 3/8-24, although this specification can vary if a different size handpiece housing and solenoid are used.
  • coaxially mounted on solenoid piston 1840 are a press fit washer 1844 and a slide fit seal 1846, disposed forwardly of washer 1844, which serves to retain seal 1846 within nosepiece 1814.
  • slide fit seal 1846 be of a particular known and commercially available variety which is formed of TEFLON ® or other similar moldable slick substance, and which is provided with an internal coil spring which biases seal 1846 radially outwardly and inwardly as the solenoid piston 1840 travels forwardly and rearwardly coaxially through both washer 1844 and seal 1846 within nosepiece 1814.
  • Nosepiece 1814 is illustrated in Figs. 2, 3, 5A and 6 as having a shape substantially that of a truncated cone with a male threaded forwardmost tip 1848.
  • Threaded end 1848 is suitably formed to selectively removably engage in the usual manner the female threaded hub 1870' of a guillotine type ophthalmic scissor, such as that previously mentioned and as illustrated, for example only, in Fig. 2 at 1870.
  • the male thread provided on end 1848 is preferably #10-32.
  • Nosepiece 1814 has a gripping end 1849 with a smooth, sloped outer surface, tapering forwardly to tip 1848, for example of polished stainless steel with which the entire nosepiece 1814 is preferred to be formed.
  • the forwardly angled gripping portion 1849 can be coated, at least in part, with some other substance, such as silicone or an elastomer in such manner that the surface is still smooth, or molded so as to have ridges, such as those indicated at 1850 in Figs.
  • Figs. 4 and 5 illustrate a central longitudinal aperture 1852 within nosepiece 1814 through which the actuator pin (not shown) of scissors 1870 is contacted endwise by the forwardly directed, tip 1841 of solenoid piston 1840, when piston 1840 is in the actuated position shown in solid lines in Fig. 9.
  • the broken lines in Fig. 9 illustrate the position of piston 1840 in a de-energized, retracted state to which the piston returns after actuating the surgical instrument. Ordinarily return to this position (indicated at 1843 in Fig. 9) is caused, at least in part, by a known spring mechanism within hub 1870.
  • nosepiece 1814 consists of an annular flat surface 1854, illustrated in Fig. 4, which faces the forwardly directed end of solenoid 1836.
  • nosepiece 1814 Internally of end face 1854, nosepiece 1814 has a straight, cylindrical wall which is sized and female- threaded to receive to corresponding male-threaded end 1842 of solenoid 1836.
  • end face 1854 extends radially outwardly until intersecting a straight annular outer side wall 1856.
  • the edge of the intersection between end face 1854 and side wall 1856 may be chamfered, as shown, if desired for comfort and convenience of use.
  • Outer side wall 1856 is provided with preferably at least three (equally spaced apart) , but necessarily at least one, transverse, internally threaded hole 1858 for receiving known set screws (e.g. #2-56 screws, not shown) in the usual manner to thereby attach threaded end 1842 of solenoid 1836 in a preselected position longitudinally within nosepiece 1814, as will be described further hereafter.
  • known set screws e.g. #2-56 screws, not shown
  • Outer side wall 1856 is desirably provided with a formed annular groove 1860 for receiving a conventional O-ring 1862 so that nosepiece 1814 fits tightly against the cylindrical inner side wall of housing 1812.
  • Annular groove 1860 is seen most clearly in Fig. 9, where the O-ring is omitted.
  • O-ring 1862 is shown in Fig. 2, and in section in Figs. 3 and 6.
  • a pair of ledges or shoulders shown most clearly in the schematic figures 5A and 9, and indicated at 1864 and 1866.
  • a straight sided annular wall 1868 extends between shoulders 1864 and 1866 and provides a circumferential boundary for slide fit seal 1846 as the solenoid piston 1840 travels longitudinally during actuation and return.
  • Wall 1868 terminates forwardly in inwardly directed annular shoulder 1866 and forms an outward boundary for slide fit seal 1846.
  • Press fit washer 1844 which seats against shoulder 1864 rearwardly of seal 1846 and is press fit against the inside wall of the nosepiece.
  • handpiece 1810 is formed of materials which are durable and amenable to being repeatedly cleaned and disinfected without readily breaking down. Further, as discussed, the general form of handpiece 1810 can be varied somewhat and still function adequately. It is necessary, however, that the solenoid piston be positioned in axial alignment with the tip of the actuating pin of the scissors. For the preferred assembly, of course, the nosepiece described herein, or its functional equivalent is necessary. With reference to Fig. 5A, the following dimensions for the distances indicated in the figure by arrows a - g are provided as an example of nosepiece 1814 constructed within the scope of the invention. It is to be understood that the figures provided are not intended to be limiting, but only exemplify a preferred form of nosepiece 1814.
  • the preferred dimensions for nosepiece 1814 are: a - .450, b - .240, c - 1.031, d - .906, e - .406, f - .146, and g - .094/.104.
  • sequence of steps to assemble the nosepiece assembly i.e.
  • the nosepiece, solenoid and solenoid plunger with slide fit seal and press fit washer) of handpiece 1810 is as follows: 1) slide fit seal 1846 and press fit washer or bushing 1844 are installed into nosepiece 1814, 2) threaded end 1842 of solenoid 1836 is screwed onto nosepiece 1814, 3) solenoid plunger 1840 is inserted into solenoid 1836, forwardly toward nosepiece 1814, 4) while holding solenoid plunger 1840 in the previously mentioned seated position within solenoid 1836, nosepiece 1814 is rotated to achieve a previously determined gauge setting (or a calibration value with a dial indicator); i.e., tip 1841 of plunger 1840 is positioned longitudinally relative to nosepiece 1814 for proper functioning of scissors 1870, and 5) the set screws are installed transversely into nosepiece 1814 and tightened against threaded end 1842 of solenoid 1836 to secure nosepiece 1814 to solenoid 1836 in the preselected longitudinal position.
  • handpiece 1810 is preset so that no adjustment or additional assembly is required by the surgeon. Rather, the user should not attempt to disassemble the handpiece, as doing so would more than likely disrupt the carefully calibrated positioning of the solenoid plunger relative to the tip of the nosepiece, i.e., relative to the actuated needle tip of the surgical instrument detachably connected to the nosepiece.

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  • Heart & Thoracic Surgery (AREA)
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  • Veterinary Medicine (AREA)
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  • Ophthalmology & Optometry (AREA)
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  • General Business, Economics & Management (AREA)
  • Epidemiology (AREA)
  • Primary Health Care (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Pathology (AREA)
  • Surgical Instruments (AREA)
  • Eye Examination Apparatus (AREA)
  • Prostheses (AREA)
  • Manipulator (AREA)
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  • Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)

Abstract

L'invention concerne un système pour commander plusieurs instruments microchirurgicaux ophtalmiques. Elle se rapporte plus particulièrement à une pièce à main (1810) conçue pour activer un instrument chirurgical (tels que des ciseaux) connecté à la pièce à main, laquelle (1810) comporte un boîtier (1812) et un activateur linéaire (1836) retenu de manière active à l'intérieur de ce dernier. Un embout (1814) monté sur une extrémité du boîtier est conçu pour la correction d'un instrument chirurgical actionné de manière linéaire. Ledit embout (1814) est fixé à l'activateur linéaire (1836) dans une position de référence présélectionnée par rapport à l'axe longitudinal de l'activateur linéaire.
EP97940679A 1996-08-29 1997-08-28 Piece a main chirurgicale Expired - Lifetime EP0949881B1 (fr)

Applications Claiming Priority (5)

Application Number Priority Date Filing Date Title
US2549896P 1996-08-29 1996-08-29
US25498P 1996-08-29
US72139196A 1996-09-26 1996-09-26
US721391 1996-09-26
PCT/US1997/015203 WO1998008449A1 (fr) 1996-08-29 1997-08-28 Piece a main chirurgicale

Publications (3)

Publication Number Publication Date
EP0949881A1 EP0949881A1 (fr) 1999-10-20
EP0949881A4 true EP0949881A4 (fr) 2001-04-11
EP0949881B1 EP0949881B1 (fr) 2004-10-13

Family

ID=26699814

Family Applications (13)

Application Number Title Priority Date Filing Date
EP97938540A Expired - Lifetime EP0955984B1 (fr) 1996-08-29 1997-08-22 Commande de frequence et de puissance a deux boucles
EP97939636A Ceased EP0955899A4 (fr) 1996-08-29 1997-08-28 Unite de commande au pied pour systeme microchirurgical
EP07123035A Withdrawn EP1925274A3 (fr) 1996-08-29 1997-08-28 Clavier numérique simulé sur écran tactile
EP05075313A Withdrawn EP1550405A3 (fr) 1996-08-29 1997-08-28 Unité de commande au pied pour système microchirurgical
EP05075314A Withdrawn EP1550406A3 (fr) 1996-08-29 1997-08-28 Unité de commande au pied pour système microchirurgical
EP97939657A Ceased EP0951241A4 (fr) 1996-08-29 1997-08-28 Systeme microchirurgical ophtalmique dans lequel des modules a memoire flash et reprogrammables sont utilises
EP97940684A Expired - Lifetime EP1006892B1 (fr) 1996-08-29 1997-08-28 Systeme chirurgical permettant une reconfiguration automatique
EP97941377A Ceased EP1006894A4 (fr) 1996-08-29 1997-08-28 Clavier numerique simule sur ecran tactile
EP97940672A Withdrawn EP1006891A1 (fr) 1996-08-29 1997-08-28 Systeme microchirurgical ophtalmique
EP97940683A Expired - Lifetime EP0929263B1 (fr) 1996-08-29 1997-08-28 Systeme microchirurgical pourvu d'une pluralite de modes/fonctions chirurgicales
EP97940679A Expired - Lifetime EP0949881B1 (fr) 1996-08-29 1997-08-28 Piece a main chirurgicale
EP06009956A Withdrawn EP1704839A1 (fr) 1996-08-29 1997-08-28 Module chirurgical à communication avec circuits intégrés neuronaux
EP97941376A Ceased EP1006893A4 (fr) 1996-08-29 1997-08-28 Module chirurgical a communication a circuits integres neuronaux

Family Applications Before (10)

Application Number Title Priority Date Filing Date
EP97938540A Expired - Lifetime EP0955984B1 (fr) 1996-08-29 1997-08-22 Commande de frequence et de puissance a deux boucles
EP97939636A Ceased EP0955899A4 (fr) 1996-08-29 1997-08-28 Unite de commande au pied pour systeme microchirurgical
EP07123035A Withdrawn EP1925274A3 (fr) 1996-08-29 1997-08-28 Clavier numérique simulé sur écran tactile
EP05075313A Withdrawn EP1550405A3 (fr) 1996-08-29 1997-08-28 Unité de commande au pied pour système microchirurgical
EP05075314A Withdrawn EP1550406A3 (fr) 1996-08-29 1997-08-28 Unité de commande au pied pour système microchirurgical
EP97939657A Ceased EP0951241A4 (fr) 1996-08-29 1997-08-28 Systeme microchirurgical ophtalmique dans lequel des modules a memoire flash et reprogrammables sont utilises
EP97940684A Expired - Lifetime EP1006892B1 (fr) 1996-08-29 1997-08-28 Systeme chirurgical permettant une reconfiguration automatique
EP97941377A Ceased EP1006894A4 (fr) 1996-08-29 1997-08-28 Clavier numerique simule sur ecran tactile
EP97940672A Withdrawn EP1006891A1 (fr) 1996-08-29 1997-08-28 Systeme microchirurgical ophtalmique
EP97940683A Expired - Lifetime EP0929263B1 (fr) 1996-08-29 1997-08-28 Systeme microchirurgical pourvu d'une pluralite de modes/fonctions chirurgicales

Family Applications After (2)

Application Number Title Priority Date Filing Date
EP06009956A Withdrawn EP1704839A1 (fr) 1996-08-29 1997-08-28 Module chirurgical à communication avec circuits intégrés neuronaux
EP97941376A Ceased EP1006893A4 (fr) 1996-08-29 1997-08-28 Module chirurgical a communication a circuits integres neuronaux

Country Status (9)

Country Link
EP (13) EP0955984B1 (fr)
JP (11) JP4094063B2 (fr)
CN (10) CN1182818C (fr)
AU (10) AU724661B2 (fr)
BR (5) BR9711288A (fr)
CA (9) CA2264663C (fr)
DE (4) DE69728793T2 (fr)
ES (4) ES2222518T3 (fr)
WO (11) WO1998008479A1 (fr)

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